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1174203467
MATT AMIDAN
MOAB, UT
NPI
1174203467
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: UT 7550499-1701)
Enumeration Date
2023-07-20
Last Update Date
2023-07-20
Business Address
MATT AMIDAN
290 S MAIN ST
MOAB, UT 84532-2596
Phone number: 435-313-2012
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Mailing Address
MATT AMIDAN
290 S MAIN ST
MOAB, UT 84532-2509
Phone number: 435-313-2012
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